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The diving medical detectives: when diving medicine books are completely wrong, Part II of DOI: 10.13140/RG.2.2.15199.79528

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Abstract

Abstract / Methods / Results: as per Part I. i.e.: DOI: 10.13140/RG.2.2.15199.79528 We compiled lists/descriptions of errors found in the standard diving medicine literature. We scanned our diving medicine archives and looked there for already existing error-reports; typos etc. were ignored. Severe errors are appearing more frequently in monographs. Omnibus Volumes, written by teams of experts, are obviously more resilient to errors. Discussion / Recommendations: Single authors / editors should consult with expert teams prior to publication. If you want to contribute s.th. to our list, we would be very happy if you send an e-mail to our head of lab: director@smc-de.com
1
The diving medical detectives:
when diving medicine books
are completely wrong
17.09.2021, Part II
Miri Rosenblat, TAU
Nurit Vered, Technion Haifa
Yael Eisenstein,
SubMarineConsulting
DOI: tbd.
2
The diving medical detectives:
when diving medicine books
are completely wrong, Part II
Abstract / Methods / Results:
as per Part I:
DOI: 10.13140/RG.2.2.15199.79528
Severe errors are appearing more frequently in monographs. Omnibus
Volumes, written by teams of experts, are obviously more resilient to errors.
Discussion / Recommendations:
Single authors / editors should consult with expert teams prior to
publication.
If you want to contribute s.th. to our list, we would be very happy if you send
an e-mail to our head of lab: director@smc-de.com
(That is: to be continued with Part III )
3
[75]
p. 60, Fig. 4-10 bottom; maybe, this is not a real,
severe error, but the original manual from the
ORCA Edge® (LHS) does not mention any
„Experience“. The „Edge“ was coined by Dan Orr,
as an „Electronic Dive Guide“ …
Since this was an eyecatcher for us, we decided to scrutinize this page
in-depth, and found more
4
[75], continued
p. 60, top, Tables 4-1 & 4-2; if you ignore the somewhat
misleading legend (LHS) then table 4-1 is self-consistent:
if you start with the M0-values in row 4, divide these by 33
you get the Tissue ratios in row 3, dividing these ones by .79
you get the Haldane ratios in row 2:
5
[75], continued
p. 60, top, Table 4-2; the M0 values from Table 4-1 should
then appear in Table 4-2 as the 2nd. row, i.e. SAD = Dnext = 0;
this is OK for HT 5 & 10 min (yellow display). But for the HT 20 to 120 min
these M0 do not match. Especially the M0 with 33 fsw for HT 240 min would
imply zero-supersaturation: a little bit annoying for real-world diving
6
[75], continued
On p. 59 it is insinuated that these M-values have
something to do with the US Navy.
But by comparison with
the ultimate source
on M-values,
i.e. Bob Workmans
NEDU Report 6-65 [a];
on p. 31 we found that
neither all the M-values
(2nd. column, D = 10 ft.)
as such and as well, nor
the ΔM match, i.e.
the Tables 4-1 & 4-2
are,
to put it mildly,
only partially useful to
the inclined reader.
7
[4], [4a], [5], [5a], [65], [234]:
In part I we promised to have a look at our collection of Albert Alois
Bühlmanns most prominent books.
[65]
[4] [234]
[5]
[5a]
[4a]
8
[4], [4a], [5], [5a], [65], [234]
Basis of the following slides # 8 - 14 are the
presentations of Albi,
pls. cf. the references [b] & [c].
[234] & [4]:
Since [234] is the english version of [4], it should be an exact translation:
It is not.
The a-& b-coefficients for the ZH-L12 differ for a couple of the compartments,
(# 3, 7, 10 16; red display on the next slide) and, thus, a couple of the
calculated run-times and decompression table comparisons diverge between
the 2 books (for eg. p. 31).
An a-posteriori validation, like the one we did in [c], will therefore not work.
[234] finds the ZH-L12 set on p. 27, in [4] on p. 27; pls. cf. the next 2 slides:
9
[234], p.27:
10
[4], p. 27:
11
[65], p. 158, pls. cf. next slide:
The b-coefficient of compartment # 4 (HT= 18.5 min) is 0.7825
(yellow display).
By using AAB‘s own formula to derive the a- & b-coefficients from the HT
(formula ibd. on p. 129) it should be 0.7725
For real-world diving this is fortunately positive:
the tolerated inert-gas pressure pt,tol goes down from ca. 2.05 to ca. 2.03 Bar
As well for compartment # 5 the b-value, derived by the formula on p. 129,
is 0.81254991 (= 0.8125) but here rounded up to 0.8126 (red line).
12
[65], p. 158:
13
[65], p. 114:
instead of 1.1 1.24
[65], p. 119:
instead of the old ZH-L coefficients; with the 50:50 balanced new ones
(0.3723 & 0.946) it should read 0.9968
[65], p. 12, Tabelle 1:
for 1 Bar inspired air the Vol.-% of N2 & O2 do not match (col. 3); it
seems rather like alveolar air
the conversion factor from 1 Bar = 750.06 mm Hg seems odd,
since the 1st. diver-ballpark yields 760/1013 = 750.24.
750.2 is used in all standard references, i.e.: [62], [63], [75], [178].
By consulting the ultimate source for diving physicians on
pressure-conversions [110] on p. 893, Table A-3, there yields as well:
1 mm Hg = 1.33323 * 10 -3 Bar
14
[65], p. 146, Tabelle 22:
for this SAT-dive on air to 30 m the pinert, max is ca.
4 * 0.8 = 3.2 and not 3.6 Bar.
Either this table was calculated with another mix, which is not indicated,
or to another depth (37 m @ air), which is not indicated as well.
However, a SAT dive with air to 36.8 m fresh water would yield the used
pinert 3.6 Bar; the decompression-time with 54 h on air,
starting @ 23 m could be confirmed via DIVE [d],
pls. cf. the attachment, slide #17. Because this example SAT dive has a long
history, starting with [4] in 1983, we assume, that the then published ZH-L12
has been used to create Table 22 and not the new ZH-L 16 from [65].
[65], p. 189, Tabelle 31:
(only for the sake of completeness: the entries at
Nr. 2 do not match the cited source from DAN / DSL)
15
References:
[a] Workman, R.D. (26 May 1965) Research Report 6-65,
Calculation of Decompression Schedules for Nitrogen-Oxygen and
Helium-Oxygen Mixtures, USN NEDU, AD #620-879
[b] Salm, Albi (August 2021) Dekompression: Kapitel 14, S. 368 - 372:
Fehlerchen im Bühlmann Konvolut
[c] Salm, Albi (October 2020) ZH-L12 : Validation of an old (1982)
experimental Heliox jump dive (30 m, 120 min);
DOI: 10.13140/RG.2.2.24608.20482/1
[d] Rosenblat, Miri; Vered, Nurit (07 / 2021) PoC for DIVE Version 3_10,
http://dx.doi.org/10.13140/RG.2.2.28123.69924
*************************************************************************************
[75] "Bove and Davis' DIVING MEDICINE", Alfred A. Bove, 4 th. edition,
Saunders 2004, ISBN 0-7216-9424-1
[110] The Underwater Handbook: A Guide to Physiology and Performance for
the Engineer; Shilling, Werts, Schandelmaier; Plenum Press N.Y., 1976, ISBN
0-306-30843-6
16
References , continued:
[4] Dekompression - Dekompressionskrankheit, A. A. Bühlmann, Springer,
1983, ISBN 3-540-12514-0
[4a] Bühlmann, A. A. (1990): Tauchmedizin (Barotrauma, Gasembolie,
Dekompression, Dekompressionskrankheit), zweite Auflage, Springer, ISBN:
3-540-52533-5
[5] Tauchmedizin (Barotrauma, Gasembolie, Dekompression,
Dekompressionskrankheit) A. A. Bühlmann, Springer, 1993, ISBN 3-540-
55581-1
[5a] Bühlmann, A. A. (1995): Tauchmedizin (Barotrauma, Gasembolie,
Dekompression, Dekompressionskrankheit, Dekompressionscomputer),
vierte Auflage, Springer, 1993, ISBN: 3-540-58970-8
[65] "Tauchmedizin.", Albert A. Bühlmann, Ernst B. Völlm (Mitarbeiter), P.
Nussberger; 5. Auflage in 2002, Springer, ISBN 3-540-42979-4
[234] Bühlmann, Albert Alois (1984) Decompression - Decompression
Sickness, Springer, ISBN: 3-540-13308-9, 0-387-13308-9,
e-book 978-3-662-02409-6
17
Attachment: the SAT dive with DIVE 3_10
Adjusting Pamb to 1,000 mbar:
„L“ „1.0“
Loading the 1983 (german) ZH-L12 N2-coefficients (Δ):
„NC“ „8“
Input of the SAT profile, depth = 36.8 m, time 6000 min:
„d“ „36.8“ „6000.“
Check of decompression:
„a“
yields
The ceiling with 22.73 m
and the
TTS 3,241 min / 60 = 54.02 h
confirm
[65], p. 146, Tabelle 22.
(Δ): with the new ZH-L 16
coefficients the TTS is
ca. 61 h
18
(un-official) Coda of Part II:
We from the lab (Miri, Nurit & Yael) wanted urgently
to push this one out to RG on the morning of 09/17,
even if there is now no proof-reading & no peer-review …
This is a ןגראמ טוג! to a very special mensch, who happens
to be our boss, presently he is on SAT in the Aegean:
Presentation
Full-text available
Here, in Part V, we give only a short comment about pressure units and the various conversion factors used in diving medicine books, as the majority of these books are using imperial units like pounds per square inch (psi) or feet of seawater (fsw), but for serious scientific publications or technical documentation the SI system, the „International System of Units“ is the preferred and used system. These conversion factors are regularly not consistent over all these books as they normally do not specify (water-)temperature nor the density. So they are at times even contradicting and one thing for sure for a physician, i.e. a physical layman: confusing! For an easy and quick assessment with mental arithmetic, say for a ballpark to check absolute pressures, partial pressures of oxygen and the like, especially when required underwater, during real diving, SI is the system of choice.
Presentation
Full-text available
Abstract: We compiled lists/descriptions of errors found in the standard diving medicine literature. Methods: We scanned our diving medicine archives and looked there for already existing error-reports; typos etc. were ignored.
Presentation
Full-text available
ZH-L12: Validation of an old (1982) experimental Heliox jump dive (30 m, 120 min): Question: could we verify the old ZH-L12 decompression profile with a topical desktop deco software?
Dekompression: Kapitel 14
  • Albi Salm
Salm, Albi (August 2021) Dekompression: Kapitel 14, S. 368 -372: Fehlerchen im Bühlmann Konvolut
Völlm (Mitarbeiter), P. Nussberger; 5
  • Albert A Bühlmann
  • B Ernst
"Tauchmedizin.", Albert A. Bühlmann, Ernst B. Völlm (Mitarbeiter), P. Nussberger; 5. Auflage in 2002, Springer, ISBN 3-540-42979-4